公共卫生和公共安全机构对阿片类药物过量的后续护理：马萨诸塞州新兴项目的探索。
Post opioid overdose outreach by public health and public safety agencies: Exploration of emerging programs in Massachusetts.
机构信息
Social Science Research and Evaluation, Inc., 21-C Cambridge Street, Burlington, MA 01803, United States.
Social Science Research and Evaluation, Inc., 21-C Cambridge Street, Burlington, MA 01803, United States; Department of Psychiatry, Harvard Medical School, Harvard University, 17 Quincy Street, Cambridge, MA 02138, United States.
出版信息
Int J Drug Policy. 2018 Apr;54:43-50. doi: 10.1016/j.drugpo.2018.01.001. Epub 2018 Feb 8.
BACKGROUND
Opioid overdose is a significant public health problem. Collaborative programs between local public health and public safety agencies have emerged to connect overdose survivors and their personal networks with harm reduction and addiction treatment services following a non-fatal overdose event. This study explored the prevalence of these programs in Massachusetts and the different ways they have been structured and function.
METHODS
We sent an online screening questionnaire to police and fire departments in all 351 communities in Massachusetts to find instances in which they collaborated with a community-based public health agency to implement a post-overdose outreach and support program. We conducted telephone interviews with communities that implemented this type of program and categorized programs based on their structure, outreach approach, and other key characteristics.
RESULTS
Police and fire personnel from 110 of the 351 communities in Massachusetts (31% response rate) completed the screening survey. Among respondents, 21% (23/110) had implemented a collaborative, community-based, post-overdose program with a well-defined process to connect overdose survivors and their personal networks with support services or addiction treatment services. Using data from the interviews, we identified four types of programs: (1) Multi-Disciplinary Team Visit, (2) Police Visit with Referrals, (3) Clinician Outreach, and (4) Location-Based Outreach.
CONCLUSIONS
This study represents the first attempt to systematically document an emerging approach intended to connect opioid overdose survivors and their personal networks with harm reduction and addiction treatment services soon after a non-fatal overdose event. These programs have the potential to increase engagement with the social service and addiction treatment systems by those who are at elevated risk for experiencing a fatal opioid overdose.
背景
阿片类药物过量是一个严重的公共卫生问题。为了在非致命性阿片类药物过量事件后将过量幸存者及其社交网络与减少伤害和成瘾治疗服务联系起来，当地公共卫生和公共安全机构之间已经建立了合作项目。本研究旨在探讨这些项目在马萨诸塞州的流行情况，以及它们在结构和功能上的不同之处。
方法
我们向马萨诸塞州所有 351 个社区的警察和消防部门发送了在线筛选问卷，以寻找他们与社区公共卫生机构合作实施阿片类药物过量后外展和支持计划的实例。我们对实施这种类型项目的社区进行了电话访谈，并根据其结构、外展方法和其他关键特征对项目进行了分类。
结果
马萨诸塞州 351 个社区中的 110 个社区（31%的回复率）的警察和消防人员完成了筛选调查。在受访者中，21%（23/110）实施了一项合作性、以社区为基础的、阿片类药物过量后方案，该方案有一个明确的流程，将过量幸存者及其社交网络与支持服务或成瘾治疗服务联系起来。根据访谈数据，我们确定了四种类型的方案：（1）多学科团队访问；（2）警察访问和转介；（3）临床医生外展；（4）基于地点的外展。
结论
本研究首次尝试系统地记录一种新兴方法，旨在在非致命性阿片类药物过量事件后不久，将阿片类药物过量幸存者及其社交网络与减少伤害和成瘾治疗服务联系起来。这些方案有可能通过那些有较高风险经历致命性阿片类药物过量的人，增加他们与社会服务和成瘾治疗系统的接触。
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